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Federal Register / Vol. 70, No.

116 / Friday, June 17, 2005 / Notices 35255

Dated: June 3, 2005. from the States of ongoing Medicaid significant number of program benefits
Jim L. Wickliffe, drug costs for dual eligibles assumed by not available to nonparticipating
CMS Paperwork Reduction Act Reports Medicare under MMA, which absent the suppliers. The information associated
Clearance Officer, Regulations Development MMA would have been paid for by the with this collection is needed to identify
Group, Office of Strategic Operations and States; Form Number: CMS–10143 the recipients of the program benefits;
Regulatory Affairs. (OMB# 0938–NEW); Frequency: Frequency: Other—when starting a new
[FR Doc. 05–11722 Filed 6–16–05; 8:45 am] Recordkeeping and Monthly reporting; business; Affected Public: Business or
BILLING CODE 4120–01–P Affected Public: State, local or tribal other for-profit; Number of
government; Number of Respondents: Respondents: 6000; Total Annual
51; Total Annual Responses: 612; Total Responses: 6000; Total Annual Hours:
DEPARTMENT OF HEALTH AND Annual hours: 10,710. 1500.
HUMAN SERVICES 2. Type of Information Collection 4. Type of Information Collection
Request: New Collection; Title of Request: Extension of a currently
Centers for Medicare & Medicaid Information Collection: Claims Error approved collection; Title of
Services Rate Testing (CERT)/Electronic Medical Information Collection: Information
[Document Identifier: CMS–10143, CMS– Records Exploratory Survey; Form No.: Collection Requirements in Final Peer
10140, CMS–460, CMS–R–65] CMS–10140 (OMB# 0938–NEW); Use: Review Organization Regulations, 42
The Centers for Medicare and Medicaid CFR sections 1004.40, 1004.50, 1004.60,
Agency Information Collection Services (CMS) is using a private vendor 1004.70; Form No.: CMS–R–65 (OMB#
Activities: Submission for OMB to conduct market research to assess the 0938–0444); Use: This final rule updates
Review; Comment Request value of electronic patient medical the procedures governing the imposition
records relative to the Claims Error Rate and adjudication of program sanctions
AGENCY: Centers for Medicare & Testing (CERT) program and determine predicated on the recommendations of
Medicaid Services, HHS. what actions CMS can take to encourage Peer Review Organizations (PROs).
In compliance with the requirement the use of electronic records for the These changes are being made as a
of section 3506(c)(2)(A) of the purpose of lowering the CERT error rate. result of statutory revisions designed to
Paperwork Reduction Act of 1995, the The proposed effort will test the address health care fraud and abuse
Centers for Medicare & Medicaid hypothesis that increased functionality issues in the OIG sanction process. The
Services (CMS), Department of Health of electronic records (meaning, greater Peer Review Improvement Act of 1982
and Human Services, is publishing the connectivity and features), is associated amended Title XI of the Social Security
following summary of proposed with lower CERT error rates related to Act, creating the Utilization and Quality
collections for public comment. coding, non-response and incomplete Control Peer Review Organization
Interested persons are invited to send documentation. The project is expected program. Section 1156 of the Social
comments regarding this burden to assist CMS in identifying a strategy to Security Act imposes obligations on
estimate or any other aspect of this improve the CERT claims error rate by health care practitioners and other
collection of information, including any developing an approach that would both persons who furnish or order services or
of the following subjects: (1) The facilitate and encourage the use of items under Medicare. This section also
necessity and utility of the proposed electronic patient medical records in the provides for sanction actions, if the
information collection for the proper health care setting. This research Secretary determines that the
performance of the Agency’s function; focuses on physician practices, obligations as stated by this section are
(2) the accuracy of the estimated outpatient hospitals, durable medical not met. Quality Improvement
burden; (3) ways to enhance the quality, equipment (DME) providers and skilled Organizations (QIOs) are responsible for
utility, and clarity of the information to nursing facilities (SNFs) that have been identifying violations. QIOs may allow
be collected; and (4) the use of randomly sampled as part of the CERT practitioners or other persons,
automated collection techniques or process.; Frequency: On occasion; opportunities to submit relevant
other forms of information technology to Affected Public: Business or other for- information before determining that a
minimize the information collection profit; Number of Respondents: 1600; violation has occurred. These
burden. Total Annual Responses: 1600; Total requirements are used by the QIOs to
1. Type of Information Collection Annual Hours: 454. collect the information necessary to
Request: New collection; Title of 3. Type of Information Collection make their determinations; Frequency:
Information Collection: Monthly State Request: Extension of a currently On occasion; Affected Public: Not-for-
File of Medicaid/Medicare Dual Eligible approved collection; Title of profit institutions; Number of
Enrollees and Supporting Regulations in Information Collection: Medicare Respondents: 53; Total Annual
42 CFR 423.900 through 423.910; Use: Participating Physician or Supplier Responses: 1060; Total Annual Hours:
The monthly file of dual eligible Agreement; Form No.: CMS–460 (OMB# 22,684.
enrollees will be used to determine 0938–0373); Use: Form number CMS– To obtain copies of the supporting
those duals with drug benefits for the 460 is completed by nonparticipating statement and any related forms for the
phased-down State contribution process physicians and suppliers if they choose proposed paperwork collections
required by the Medicare Modernization to participate in Medicare Part B. By referenced above, access CMS Web site
Act of 2003 (MMA). Section 103(a)(2) of signing the agreement, the physician or address at http://www.cms.hhs.gov/
the MMA addresses the phased-down supplier agrees to take assignment on all regulations/pra/, or e-mail your request,
state contribution (PDSC) process for the Medicare claims. To take assignment including your address, phone number,
Medicare program. The reporting of the means to accept the Medicare allowed OMB number, and CMS document
Medicare/Medicaid dual eligibles on a amount as payment in full for the identifier, to Paperwork@cms.hhs.gov,
monthly basis is necessary to implement services they furnish and to charge the or call the Reports Clearance Office on
those provisions, and to Support Part D beneficiary no more than the deductible (410) 786–1326.
subsidy determinations and auto- and coinsurance for the covered service. Written comments and
assignment of individuals to Part D In exchange for signing the agreement, recommendations for the proposed
plans. The PDSC is a partial recoupment the physician or supplier receives a information collections must be mailed

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35256 Federal Register / Vol. 70, No. 116 / Friday, June 17, 2005 / Notices

within 30 days of this notice directly to submission of the formulary and the insurance claims payers. Submission of
the OMB desk officer: PBP software; Frequency: On occasion, information on the CMS–1450 permits
OMB Human Resources and Housing annually and other (as required by new Medicare intermediaries to receive
Branch, Attention: Christopher legislation); Affected Public: Business or consistent data for proper payment;
Martin, New Executive Office other for-profit and Not-for-profit Frequency: On occasion; Affected
Building, Room 10235, Washington, institutions; Number of Respondents: Public: Not-for-profit institutions,
DC 20503. 470; Total Annual Responses: 2,092; Business or other for profit; Number of
Dated: June 10, 2005.
Total Annual Hours: 5,546. Respondents: 51,629; Total Annual
2. Type of Information Collection Responses: 174,461,278; Total Annual
Jim L. Wickliffe,
Request: Revision of a currently Hours: 1,997,581.
CMS Reports Clearance Officer, Regulations approved collection; Title of 4. Type of Information Collection
Development Group, Office of Strategic
Information Collection: National Request: New Collection; Title of
Operations and Regulatory Affairs.
Medicare Education Program (NMEP); Information Collection: Notice of Denial
[FR Doc. 05–11929 Filed 6–16–05; 8:45 am]
Form No.: CMS–R–254 (OMB # 0938– of Medicare Prescription Drug Coverage;
BILLING CODE 4120–01–P
0738); Use: The NMEP was developed to Form No.: CMS–10146 (OMB # 0938–
inform people with Medicare, their NEW); Use: Pursuant to 42 CFR
family members, and other interested 423.568(c), if a Part D plan denies drug
DEPARTMENT OF HEALTH AND
parties about their Medicare options. coverage, in whole or in part, the Part
HUMAN SERVICES
The Medicare Modernization Act of D plan must give the enrollee written
Centers for Medicare & Medicaid 2003 expanded the program to include notice of the coverage determination;
Services among other things, a new Prescription Frequency: Other: Distribution; Affected
Drug Benefit; therefore, this package has Public: Business or other for profit, Not-
[Document Identifier: CMS–R–262, CMS–R– been revised to include this for-profit institutions; Individuals or
254, CMS–1450, CMS–10146, CMS–10147, information. The NMEP employs Households and Federal Government;
CMS–10154, and CMS–10160]
numerous communication channels to Number of Respondents: 450; Total
Agency Information Collection educate people with Medicare and help Annual Responses: 1,056,000; Total
Activities: Proposed Collection; them make more informed decisions Annual Hours: 528,000.
Comment Request concerning the Medicare program 5. Type of Information Collection
benefits; health plan choices; Request: New Collection; Title of
AGENCY: Centers for Medicare & supplemental health insurance; rights, Information Collection: Medicare
Medicaid Services, HHS. responsibilities, and protections; and Prescription Drug Coverage and Your
In compliance with the requirement preventive health services. As part of Rights; Form No.: CMS–10147 (OMB #
of section 3506(c)(2)(A) of the the NMEP, CMS must provide 0938–NEW); Use: Pursuant to 42 CFR
Paperwork Reduction Act of 1995, the information to this population about the 423.562(a)(3), a Part D plan sponsor
Centers for Medicare & Medicaid Medicare program and their Health Plan must arrange with its network
Services (CMS) is publishing the options, as well as information about pharmacies to post or distribute notices
following summary of proposed the new prescription drug coverage to informing enrollees to contact their plan
collections for public comment. help them choose the option that is right to request a coverage determination or
Interested persons are invited to send for them. This survey seeks to assess the an exception if the enrollee disagrees
comments regarding this burden awareness, knowledge, understanding with the information provided by the
estimate or any other aspect of this and experiences of people with pharmacy; Frequency: Other:
collection of information, including any Medicare regarding the Medicare Distribution; Affected Public: Business
of the following subjects: (1) The program overall and these new or other for profit, Not-for-profit
necessity and utility of the proposed initiatives; Frequency: On occasion; institutions; Individuals or Households
information collection for the proper Affected Public: Individuals or and Federal Government; Number of
performance of the agency’s functions; Households; Number of Respondents: Respondents: 41,000; Total Annual
(2) the accuracy of the estimated 5,700; Total Annual Responses: 5,700; Responses: 35,000,000; Total Annual
burden; (3) ways to enhance the quality, Total Annual Hours: 1,425. Hours: 583,333.
utility, and clarity of the information to 3. Type of Information Collection 6. Type of Information Collection
be collected; and (4) the use of Request: Extension of a currently Request: New collection; Title of
automated collection techniques or approved collection; Title of Information Collection: Physician
other forms of information technology to Information Collection: Medicare Assessment of Hospital Quality Reports;
minimize the information collection Uniform Institutional Provider Bill and Form No.: CMS–10154 (OMB # 0938–
burden. Supporting Regulations in 42 CFR NEW); Use: This assessment will
1. Type of Information Collection 424.5; Form No.: CMS–1450 (OMB # monitor the attitudes and behaviors of
Request: Extension of a currently 0938–0279); Use: Section 42 CFR physicians as they relate to the concerns
approved collection; Title of 424.5(a)(5) requires providers of services of their patients who have been exposed
Information Collection: Plan Benefit to submit claims prior to Medicare to hospital quality-of-care reports at
Package (PBP) and Formulary reimbursement. Charges are coded by CMS’s Web site; Affected Public:
Submission for Medicare Advantage revenue codes. The bill specifies Individuals or Households; Number of
(MA) Plans and Prescription Drug Plans diagnoses according to the International Respondents: 1730; Total Annual
(PDPs); Form No.: CMS–R–262 (OMB # Classification of Diseases, Ninth Edition Responses: 1730; Total Annual Hours:
0938–0763); Use: Under the Medicare (ICD–9–CM) code. Inpatient procedures 345.75.
Modernization Act (MMA), Medicare are identified by ICD–9–CM codes, and 7. Type of Information Collection
Advantage (MA) and Prescription Drug outpatient procedures are described Request: New collection; Title of
Plan (PDP) organizations are required to using the Healthcare Common Information Collection: The Personal
submit plan benefit package information Procedure Coding System (HCPCS). Responsibility Survey; Form No.: CMS–
to CMS for approval. Organizations will These are standard systems of 10160 (OMB # 0938–NEW); Use: New
provide this information through the identification for all major health focus on personalizing messages by

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